Melanie Dillahunt
Clayton,NC
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
8
8
years of professional experience
Work History
Benefits Specialist
Conduent
09.2022 - 08.2024
- Assist employees through the benefits enrollment process
- Explain health and wellness benefits, life insurance, long-term and short-term disability insurance options, 401(K) plan, flexible spending accounts and other benefits offered
- Assist participants with annuity payment process and benefits commencement process
- Research and assist with payment issues and check processing issues
- Assisted participants with the website issues and troubleshooting.
Disability Analyst
07.2021 - 06.2022
- Makes medical entitlement decisions on Social Security Disability Insurance, and Medicaid disability claims
- Analyze and develop complex medical, vocational, functional and programmatic data to determine whether an individual is eligible for benefits
- Assess impairment severity, propose a statement of residual functional capacity and determine an applicant's ability to engage in productive work
- Adhere to tight deadlines, high quality demands and high work volume expectations
- Read electronic images of medical records
- Strong written and verbal communication skills
- Documented experience providing customer service to the public
- Demonstrated analytical and problem-solving skills
- Proficiency in use of computer applications and keyboarding skills.
Administrative Assistant
NC Department of Health and Human Services
11.2019 - 06.2021
- Responsible for managing calendars for 3 managers
- Schedule meetings and conference calls
- Create and update documents and charts
- Create and update business procedures as needed
- Research and monitor provider enrollment applications
- Receive, analyze, and respond to provider inquires
- Receive and process reports from other government agencies
- Update provider records according to established procedures and contracts
- Create and update tracking logs
- Proficient with Microsoft Office and NCTracks.
Customer Advocate
Teletech, Inc
07.2018 - 11.2019
- Handle inbound and outbound inquiries and complaints using standard scripts and procedures
- Verify medical coverage and eligibility
- Investigate and gather information about benefits and claims to insure correct application of benefits
- Communicate appropriate options for resolution in a timely manner
- Multitask between several internal systems
- Document all decisions, correspondences and discussions.
Patient Account Representative
Healthcare Fiscal Management
05.2016 - 06.2017
- Obtain detailed personal, financial and asset information to determine if patient qualifies for Medicaid/SSI programs
- Explain the programs and advise patients of the methods to become eligible for available programs
- Complete or assists the patient with completion of Medicaid application
- Follows through with applicants to obtain accurate and complete information within strict timeframes
- Knowledge of various rules and regulations governing the ten Medicaid programs
- Interpret and apply frequent changes in program regulations to expedite applications
- Review denials from Medicaid/SSI and discuss denial information with patients
- Advocates for patient coverage with local and state Medicaid offices to obtain reversal of initial denial
- Abstracts information, prepares appeals and represents UNC Health Care System in appeal hearings at local, state (Division of Medical Assistance), Office of Administrative Hearings, and state court to present supportive evidence for patient's denial reversal.
Education
Bachelor of Arts - Criminal Justice
Shaw University
05.1995
Bachelor of Arts - Social Work
Univerisity of Phoenix
Phoenix, AZSkills
- Proficient in MS Office Suite
- Benefits Explanation
- Employee Relations
- Policy Interpretation
- Relationship Building
- Benefits Administration
- Documentation And Reporting
- Verbal and written communication
Timeline
Benefits Specialist
Conduent
09.2022 - 08.2024
Disability Analyst
07.2021 - 06.2022
Administrative Assistant
NC Department of Health and Human Services
11.2019 - 06.2021
Customer Advocate
Teletech, Inc
07.2018 - 11.2019
Patient Account Representative
Healthcare Fiscal Management
05.2016 - 06.2017
Bachelor of Arts - Criminal Justice
Shaw University
Bachelor of Arts - Social Work
Univerisity of Phoenix